Provider Demographics
NPI:1871079921
Name:AMAILUK, PAUL (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:AMAILUK
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 SW 72ND AVE APT 619
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7786
Mailing Address - Country:US
Mailing Address - Phone:305-484-8824
Mailing Address - Fax:
Practice Address - Street 1:9333 SW 152ND STREET
Practice Address - Street 2:ORAL AND MAXILLOFACIAL SURGERY DEPARTMENT
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157
Practice Address - Country:US
Practice Address - Phone:305-251-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRP18941223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery